Need help understanding new health insurance options? ARH Certified Application Counselors can help

12/13/2013

If you watch national news programs, then you have heard about the Affordable Care Act (often referred to as Obamacare) and the fact that all Americans are required by law to enroll in a health insurance plan no later than March 31, 2014. But you may not have heard that Appalachian Regional Healthcare (ARH) wants to help make the process easier for you by having key ARH Certified Application Counselors available at all its hospitals to assist you.

 

“At ARH we understand how our patients and the community might be confused by the Affordable Care Act and all its rules and regulations,” said John Snodsmith, ARH Systemwide Director for Patient Financial Services. “That’s why several ARH staff received training from the State to become Certified Application Counselors.  ARH staff can answer your questions about new Medicaid eligibility requirements and available health insurance plans.”

 

The Affordable Care Act was passed by Congress to provide Americans better access to health care coverage. The Federal Poverty Level (FPL), which is issued each year by the Department of Health and Human Services, is the guide used for obtaining health insurance coverage.  Individuals who earn more than 400% of the Federal Poverty Level (FPL) may purchase insurance through the Health Benefits Exchange, those with income between 138% and 400% of the FPL will receive premium subsidies for insurance purchased through the exchange and those who earn less than 138% of the FPL are eligible for Medicaid (see 2013 FPL chart).

 

“Individuals who were not eligible for Medicaid previously may be now due to the expanded Medicaid guidelines,” noted Snodsmith. “It is also important to know that if you are currently enrolled in the Disproportionate Share Hospital (DSH) program, the DSH program will not be available in 2014.”

 

ARH patient Joseph J. Buska, Jr. was not eligible for Medicaid, but did meet the guidelines for the DSH program and was enrolled into the program by an ARH financial counselor. Understanding that the new Affordable Care Act takes effect on January 1, 2014, Buska had many questions and turned to an ARH Certified Application Counselor for help.

 

“I was worried about losing my DSH coverage and trying to pay for health insurance,” shared Buska. “I spoke with a nice lady at ARH Hospital who explained that I now qualify for Medicaid due to the new guidelines, and she gave me the toll-free number to call to enroll.”

 

According to Buska, if he had not met with the ARH counselor, he would not have known that he could enroll in Medicaid.

 

“I appreciate all the help the ARH counselor gave me,” said Buska. “She took time with me and explained the enrollment process, which made it easier for me when I called to enroll. It took about 30 minutes to enroll, and I was told my coverage would begin on the first day of January.”

 

You don’t have to go online to enroll in a health insurance plan. With so many individuals trying to enroll through the website, it can be quicker to simply call them at 855-459-6328. ARH Patient Caroline Powers learned this after becoming frustrated with the website while trying to enroll.

 

“I knew which benefits I qualified for, so I went to the website to enroll,” shared Powers. “I started the enrollment process but I couldn’t finish it because the website stopped working.”

 

Frustrated with the website, Powers noted that her hometown ARH hospital was listed as a contact for assistance. She asked God to lead her to someone at ARH who could help her.

 

“I have no doubt that God led me to the lady I met at the ARH Hospital,” said Powers. “She was so kind and patient and answered all my questions about enrolling in the insurance plan.  She knew exactly what to do and talked me through the enrollment process.”

 

According to Powers, the ARH counselor went above and beyond to help her.

 

When I was ready to make the call to enroll, she dialed the phone number for me,” shared Powers. “While on the call if I didn’t understand something that was asked of me, she explained it so I could respond. She was my angel that day, and I am so grateful that she and ARH Hospital cared enough to help me with the enrollment process.”

 

“ARH is committed to assisting individuals in all its communities and helping them determine if they qualify for Medicaid or other affordable health insurance plans,” concluded Snodsmith.

 

For health insurance coverage on January 1, 2014, you need to enroll in an insurance plan by December 23, 2013. Please call or visit your local ARH hospital.  ARH Certified Application Counselors will answer your questions and explain Medicaid guidelines and the different health insurance plans available for you and your family.

 

 

SIDEBAR ___________________________________________________________________

 

FPL depends on family size--the larger the family, the higher the FPL. Use this chart to determine which health insurance plans work for you and your family.

 

 

 

 

 

 

 

 

 

 

 

 

Percent of Federal Poverty Level for 2013

 

Persons in Family / Household

100%

138%

400%

1

$11,490

15,856

45,960

2

15,510

21,404

62,040

3

19,530

26,951

78,120

4

23,550

32,499

94,200

5

27,570

38,047

110,280

6

31,590

43,594

126,360

7

35,610

49,142

142,440

8

39,630

54,689

158,520

 

 

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ARH is a not-for-profit health system serving 350,000 residents across Eastern Kentucky and Southern West Virginia. Operating 10 hospitals, multi-specialty physician practices, home health agencies, HomeCare Stores and retail pharmacies, ARH is the largest provider of care and single largest employer in southeastern Kentucky and the third largest private employer in southern West Virginia.

The ARH system employs nearly 5,000 people and has a network of more than 600 active and courtesy medical staff members representing various specialties. Firmly committed to its mission of improving the health and promoting the well-being of all people in Eastern Kentucky and Southern West Virginia, in the past 12 months alone, ARH provided nearly $142.8 million in uncompensated care for the uninsured and underinsured.

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